Choking hazards for babies and toddlers: the full list

Why some foods are riskier

The AAP says choking is a leading cause of death for infants and young children, and that small, round objects, including some foods, cause the most choking deaths. Young children may try to swallow food whole when they don’t grind or chew it well.

The foods on this list are risky because they are small and round, hard or sticky, which makes them hard to chew and swallow and able to block a small airway. A trial in New Zealand found that 94% of 12-month-olds had been offered at least one food posing a choking risk during a 3-day food record. Most families have these foods at home, so it helps to know the list well.

This list combines the CDC (based on the USDA WIC list), AAP and NHS lists. No list covers every food. If a food is hard, round or sticky, treat it with care.

Fruits and vegetables

• Uncut grapes, cherries, berries and melon balls. Safer: remove pits, then cut into quarters lengthwise. Squash blueberries flat for young babies.
• Uncut cherry or grape tomatoes. Safer: quarter lengthwise.
• Hard raw vegetables and fruit, like raw carrot or apple. Safer for babies: steam or simmer until soft, or grate finely.
• Whole corn kernels, cooked or raw. Safer: mash or blend cooked corn.
• Whole pieces of canned fruit. Safer: cut into small soft pieces or mash.
• Raisins and other dried fruit. The CDC lists uncooked dried fruit, such as raisins, as a choking hazard for young children, and the NHS says don’t give whole raisins or dried fruit to babies under 1. After 1, keep cutting dried fruit into small pieces (NHS): the CDC gives no age when whole raisins become safe. Safer for babies: cook or soak until soft, then chop finely and stir into soft food like oatmeal.
• Hard pips and stones. Always remove them.

Proteins

• Whole or chopped nuts and seeds (the AAP singles out sunflower seeds). Safer: finely ground into food, or smooth nut butter spread thinly. No whole nuts before 4 years (AAP) or 5 years (NHS).
• Spoonfuls or chunks of nut and seed butters. Safer: spread thinly on toast or stir into porridge or yogurt.
• Hot dogs, sausages and meat sticks. Under 1, skip them. For toddlers: cut lengthwise into thin strips, then short pieces, and peel off the skin. Never round coins.
• Tough or large chunks of meat. Safer: thin strips, finely shredded or minced and cooked soft.
• Bones in meat or fish. Always remove them. Flake fish like salmon and check carefully.
• Whole beans. Safer for babies: mash or flatten soft-cooked beans.
• Large chunks of cheese, especially string cheese. Safer: grate, or cut into short, narrow strips.

Grains and snacks

• Popcorn. Not suitable for young children. The NHS says no popcorn under 5 years.
• Potato or corn chips, pretzels and similar hard snacks. Skip them.
• Crackers or breads with seeds, nut pieces or whole grain kernels. Choose plain versions.
• Whole cooked grain kernels like barley or wheat berries. Safer: cook and finely grind or mash them.
• Cookies and granola bars. Skip them.
• Plain wheat germ. The CDC lists it as a food to avoid.
• Soft white bread. The NHS notes it can form a dough-like ball. Safer: lightly toasted or brown bread, cut into narrow strips.

Sweets and other foods

• Hard, round, gooey or sticky candy, including jelly beans, caramels, gum drops, gummies and cough sweets
• Chewy fruit snacks
• Chewing gum
• Marshmallows
• Raw jelly cubes (NHS)
• Ice cubes (NHS)

The CDC also notes that foods with added sugars or sweeteners aren’t recommended for babies and young children. See foods to avoid.

How long to keep these foods off the menu

The AAP suggests keeping high-risk foods away from children until 4 years or older, depending on their development. Round, firm foods like grapes and hot dogs can be served before then only if they’re changed first: grapes quartered lengthways, and hot dogs cut lengthways into thin strips, never coins. For how to cut each food, see safe food sizes and shapes.

Habits that lower the risk

• Sit your child upright in a high chair or at the table for every meal and snack.
• Stay with them and watch the whole time they eat.
• No eating while walking, running, playing, lying down, or in the car or stroller.
• Keep mealtimes calm, and don’t rush.
• Watch older brothers and sisters, who may share risky foods or small toys.
• Keep small objects like coins, marbles, balloons, toy parts and button batteries out of reach. Button batteries can also cause internal burns if swallowed.

If your child is choking

Gagging is noisy and normal. Choking is quiet: weak or no cough, no crying, struggling to breathe. Read gagging vs. choking for full first aid steps.

Shout for help, and have someone call 911. If you’re alone and your phone is with you, call on speaker and start back blows straight away. Don’t leave your baby to find a phone. For a baby under 1, give up to 5 back blows, then up to 5 chest thrusts, and repeat until the object comes out or help arrives. For a child over 1, use back blows and abdominal thrusts instead.Shout for help. For a baby under 1, start up to 5 back blows, then up to 5 chest thrusts, straight away. If the blockage hasn’t cleared after one round of each, call 999 (on speaker if you’re alone) and keep repeating back blows and chest thrusts until it clears or help arrives. For a child over 1, use back blows and abdominal thrusts instead.Shout for help, and have someone call your local emergency number (such as 112 in Europe or 000 in Australia). If you’re alone and your phone is with you, call on speaker and start back blows straight away. For a baby under 1, give up to 5 back blows, then up to 5 chest thrusts, and repeat until the object comes out or help arrives. For a child over 1, use back blows and abdominal thrusts instead.

Children over 1 get back blows and abdominal thrusts instead. Even if the object comes out, get medical help.

Where US and UK advice differs

• How long to avoid whole nuts and popcorn. The AAP suggests waiting until 4 years or older for nuts, seeds and other high-risk foods. The NHS says no whole nuts or popcorn under 5 years.
• Raw vegetables and fruit. The AAP lists raw vegetables like carrot sticks and raw fruit chunks like apple pieces as foods to avoid or modify for young children. The NHS lists raw vegetable sticks and apple slices as snack ideas from 12 months, cut into narrow sticks or slices. For under-4s, cooking firm vegetables and fruit soft or grating them is the more cautious option.
• Hot dogs and sausages. The AAP lists them among foods to avoid under 1. The NHS gives cutting advice (in half, then lengthwise, skin off) and also advises limiting processed meats and avoiding salty foods like sausages for babies.